Severe Separation of the Pubic Symphysis and Prompt Orthopedic Surgical Intervention

Dunivan, Gena C.; A, Hickman; Connolly, AnnaMarie

doi:10.1097/aog.0b013e3181998bd1

Cited by 31 publications

(46 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Three articles were case series [3,18,21], the rest were reports of single cases [9,10,11,15,16,17,19,20,22,23]. …”

Section: Resultsmentioning

confidence: 99%

“…Thus, 13 articles [3,9,10,11,15,16,17,18,19,20,21,22,23] met the inclusion criteria and were analyzed in detail (table 1). Three articles were case series [3,18,21], the rest were reports of single cases [9,10,11,15,16,17,19,20,22,23].…”

Section: Resultsmentioning

confidence: 99%

“…Postpartal symphyseal widening is comparable to traumatic pelvic ring injuries. Accordingly, like in traumatic symphyseal rupture, vaginal wall tears and even severe hemorrhage are possible in the acute situation [9,10,11]. Usually, patients are treated by the application of pelvic binders and bedrest up to several weeks.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Osterhoff

Ossendorf

Ossendorf-Kimmich

et al. 2011

Gynecol Obstet Invest

View full text Add to dashboard Cite

During pregnancy, asymptomatic widening of the symphysis pubis by about one third is normal and considered physiological. However, peripartal relaxation of the symphyseal and sacroiliac ligaments may cause significant complaints conditions including pain and gait dysfunction. Usually, patients are treated by the application of pelvic binders and bed rest up to several weeks. Surgical stabilization is performed seldom, though it may be promising in selected patients. Based on 2 cases of postpartum symphyseal instability treated by surgical fixation, the current literature was reviewed systematically to evaluate the outcome and potential complications of surgical fixation of symphyseal instability. Thirteen articles met inclusion criteria and were analyzed in detail. Including the two cases presented, surgical stabilization of postpartum symphyseal instability has been described for 33 patients. In conclusion, though only based on case reports and case series, early surgical stabilization represents a decent treatment option for postpartum symphyseal instability and may be indicated by pain or walking disability alone. In regard to the clinical outcome comparing internal and external fixation, no differences were demonstrable. However, the rate of infection was higher in patients treated by external fixation. Based on these data, we propose a treatment algorithm for this injury.

show abstract

“…Three articles were case series [3,18,21], the rest were reports of single cases [9,10,11,15,16,17,19,20,22,23]. …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Osterhoff

Ossendorf

Ossendorf-Kimmich

et al. 2011

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…The present systematic review found use of physiotherapy as the main component of conservative treatment for the majority of women with SPD [1,4,7,10,12,[18][19][20][21]24,[27][28]. Most of the studies employed physiotherapy for walking reeducation, mobilization under supervision, and/or strengthening the core muscles, although only two studies detailed the stabilizing and/or strengthening exercises [10,15].…”

Section: Discussionmentioning

confidence: 99%

Diastasis of symphysis pubis and labor: Systematic review

et al. 2015

View full text Add to dashboard Cite

Abstract-Symphysis pubis diastasis (SPD) is an infrequent complication of labor that can impair womens' general health through failure of the passive stability of the pelvic girdle. Although conservative approaches are often used to decrease symptoms and interpubic separation, notably few studies have analyzed the effect of these methods on managing the symptoms of women with SPD. The purpose of this study was to review the available literature on the conservative treatment of SPD during pregnancy and labor. A computer-based search using PubMed, PEDro, and CINAHL was performed up to November 2014. We selected all studies that considered women with SPD during pregnancy or labor and treated them with conservative methods and excluded those that included surgical intervention. Eighteen studies were selected, most of which were case reports. Although the overall results of conservative treatment were unclear because of the type and design of the obtained studies, most of the studies reported bed rest in the lateral decubitus position and a pelvic girdle as basic treatments. Additionally, the few clinical trials reported recommended additional physiotherapy, including strengthening and stabilizing exercises, to reduce SPD symptoms.

show abstract

“…Failure includes: inadequate reduction, recurrent diastasis or persistent symptoms. 11,13,15 Surgical fixation of severe symphysis separation allows for earlier ambulation and ability to care for self and baby. 15 Injuries require 6-12 weeks to heal; we mobilised our patient at four weeks post-surgery as she was painfree and her social circumstances as well high risk for thrombosis necessitated earlier mobilisation.…”

Section: Introductionmentioning

confidence: 99%

Major disruption of the pelvic ring during normal vaginal delivery: A case report

Heukelum¹,

Blake²

2017

SA orthop. j.

View full text Add to dashboard Cite

Severe Separation of the Pubic Symphysis and Prompt Orthopedic Surgical Intervention

Abstract: Aggressive treatment of severe pubic symphysis separation with external fixation resulted in early ability to ambulate, void, and care for self and baby.

Cited by 31 publications

References 5 publications

Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Diastasis of symphysis pubis and labor: Systematic review

Major disruption of the pelvic ring during normal vaginal delivery: A case report

Contact Info

Product

Resources

About